1. Field of the Invention
The invention relates generally to suture passing surgical instruments and methods of passing sutures through tissues.
2. Background Art
Both open and endoscopic surgical procedures often require sutures to ligate, join or otherwise treat tissue. Sutures can be passed through tissues in many ways including cannulated needles and instruments and needle passing instruments, which usually require the use of multiple portal entry points to transfer sutures through tissues or require the use of additional instruments or devices to facilitate the passage of sutures.
In general, suture needles with attached sutures may be grasped either manually or by forceps and passed through the desired work site so knots can be tied. While the procedures are fairly simple in open surgery where most suture sites are readily accessible, in endoscopic procedures, where access to the work site may not be readily available, the surgeon may need to use auxiliary devices to grasp sutures and pass them through desired tissue.
Various instruments and techniques have been developed for surgical repairs requiring passing sutures to distant locations. For example, U.S. Pat. No. 4,781,190 to Lee discloses a two-ended needle enabling arthroscopic suturing of the interior of a joint. The two-ended needle may be either straight or curved and may be provided with eyelet intermediates at the ends of the needle. Sutures can be passed through eyelets of the needle and then through tissues by alternately passing the ends of the needle through tissues to be sutured.
U.S. Pat. No. 4,441,497 to Paudler discloses a suture passer having a plurality of flexible elongated members joined at their corresponding ends, the ends being sharpened enough to pass through desired tissue sites. Pushing the ends toward each other opens up spaces between the members into which one or more sutures may be placed. Moving the ends of the flexible members away from each other closes up the spaces to grip the sutures so that the ends of the flexible members and, consequently, the sutures, may be passed through the desired suture sites.
Referring to FIGS. 1A-1B, yet another example of a suture-advancing device as disclosed by U.S. Pat. No. 7,585,305 to Dreyfuss is shown. FIG. 1A shows the suture-advancing device 12, which includes body 14 housing shape-memory wire 17, jaw 11, hand mechanism 16 for articulating jaw 11 relative to tip 18, actuator 13, and pusher 19 for advancing wire 17 through body 14 and tip 18. FIG. 1B shows that, by actuating the hand mechanism, a surgeon may seize and maintain tissue 15 with jaw 11 and the tip and, using the pusher to urge wire 17 to push suture 10 through tissue 15.
There remains a need for improved suture passers that allow sutures to pass through tissues with minimal damage to the tissues.